Final Settlement Adjustment Process Proposed for 340B Drug Costs

Posted on April 13, 2018

The Medical Services Administration (MSA) recently released a proposed policy to establish a cost report final settlement process that would ensure hospitals uniformly report outpatient drug costs.

Under existing MSA policy, hospitals that are eligible under the federal 340B Drug Pricing Program are required to bill Medicaid the actual drug acquisition cost; this would not change under the proposal. For purposes of the hospital final settlement process only, the MSA proposes to adjust 340B drug costs from the actual acquisition cost to the hospital’s normal and customary charge when hospital upper payment limits and final settlements are determined. The MSA proposes that this change be effective for final settlements with fiscal year-ends occurring on and after Oct. 1, 2015, and that it not apply to prior settlement or settlements reopened prior to this effective date.

The MHA encourages hospitals to submit comments regarding the proposed policy to the MSA by May 4, as outlined in the proposal. The MHA will make its draft comments available in the near future. Members with questions should contact Vickie Kunz at the MHA.   

Tags: 340B Drug Pricing Program, MSA, proposed policy

Posted in: Member News

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